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Inspection on 07/09/05 for Meadowside & St Francis

Also see our care home review for Meadowside & St Francis for more information

This inspection was carried out on 7th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home works the local palliative care team and provides palliative care in the home with a team of staff who are qualified and have experience in providing such care. A full time massage therapist is available in the home (charges are detailed in the homes brochure) to help relieve stress and discomfort. Clients are assessed appropriately before admission. Visits to the home by prospective clients and/or their families are welcomed and encouraged. The manager and activities co-ordinator try to provide activities to suit both intellectual and practical abilities.

What has improved since the last inspection?

New carpet is being laid in several areas of the home. Thermostats have been installed throughout the home to ensure that radiators and pipe-work temperatures are within required limits. An appropriate assessment has been introduced to check for and reduce the risk of Legionella in the water system.

What the care home could do better:

The manager needs to ensure that all of the windows on the first floor are adequately restricted. Medicines stored in a general fridge should be stored in an airtight container and clearly marked.

CARE HOMES FOR OLDER PEOPLE Meadowside/St Francis 5 Plymbridge Road Plympton Plymouth PL7 4LE Lead Inspector Mandy Norton Unannounced 7 September 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Meadowside/St Francis Address Meadowside/St Francis, 5 Plymbridge Road, Plympton, Plymouth, Devon, PL7 4LE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01548 830258 A J & Co (Devon) Limited Mrs Gina Marie Paterson Care Home 69 Category(ies) of Old age, not falling within any other category registration, with number (25), Physical disability over 65 years of age of places (69), Terminally ill over 65 years of age (9) Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service Users aged 65 years and over PD(E) Maximum registered 69 service users (both) TI(E) Maximum registered 9 service users (both) OP Maximum registered 25 service users (both) Six named Service Users between 18 - 65 years of age Date of last inspection 07.12.04 Brief Description of the Service: Meadowside and St Francis Care Centre is situated in a residential area in Plympton, Plymouth, Devon.The Care Centre is divided into 2 units; one provides nursing care for a maximum of 44 service users (St Francis) the other provides personal care for up to 25 service users (Meadowside). The home caters for persons over the age of 65 years, male and female, with physical frailty, illness or disability.The accommodation is provided on three floors, all but 5 rooms are accessed by a passenger lift; more able service users can access the other 5 rooms by stairs or stair lift. Each unit has dedicated communal areas including lounges and dining rooms, service users from either units can socialise in either area.Some bedrooms fall below 10 square metres, a formal assessment of individual needs and consideration to choice is given when these rooms are utilised.The home benefits from spacious grounds, which are accessible to wheelchair users’, service users who have an interest in gardening are encouraged and facilitated to continue to help around the gardens.The home is owned by A.J. & Co (Devon) Ltd, who own another care home in Cornwall. Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced. It took place over 3 hours (11.10 am – 2.10 pm) and was conducted with the matron. The focus of the inspection was to look at the environment the clients live in and to assess if the requirements and recommendations from the previous inspection have been met. What the service does well: What has improved since the last inspection? What they could do better: The manager needs to ensure that all of the windows on the first floor are adequately restricted. Medicines stored in a general fridge should be stored in an airtight container and clearly marked. Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3 and 5. Comprehensive pre admission assessments are made and therefore people are admitted to the home appropriately. Clear information and opportunities to visit the home are given to people to help them to decide if they want to live at Meadowside and St Francis. EVIDENCE: The matron said that pre admission assessments are carried out by herself and/or the deputy matron. The information gathered helps them to make a decision as to whether the home can meet a persons needs and helps to inform the initial care plan should they move in. The home also receives an initial care plan from the placing authority if a client is publicly funded. An assessment already completed for a client moving into the home within the next few days was examined and found to be very informative with a lot of relevant information included in it. Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 9 The information given to relatives and prospective clients prior to admission is very informative, written in plain English and includes photographs that give an impression of the environment. The matron said that people are encouraged to visit the home prior to admission. They can visit without an appointment but if they want to meet the matron or deputy matron it is wise to make an appointment. (An appointment was arranged during the inspection). They have a tour of the home and can meet staff and chat to current clients if appropriate. Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed during this inspection EVIDENCE: Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 13 The staff show a good understanding of the patients cultural, social and recreational needs and the importance of maintaining contact with family and friends and engage the patients in a variety of ways. EVIDENCE: The matron described her efforts to ensure a range of activities are available to suit all preferences and abilities. An activities co-ordinator is employed fulltime ensuring that a variety of activities takes place within the home and grounds (weather permitting). Outings and trips are arranged on a more individual basis. A full time massage therapist/ aromatherapy is available (charges apply) and information about what she can do and a price list is in the homes brochure. Visitors were seen coming and going during the inspection and can see their relative/friend either in their own room or in the communal areas throughout the home. Some clients and visitors were enjoying sitting in the garden, where there was suitable seating and a covered area if necessary. The brochure states that visitors are welcome to the centre. Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed during this inspection EVIDENCE: Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21,24 and 26 The standard of the environment within the home and the grounds is good providing clients with attractive and homely place to live. The overall quality of the furniture and fittings is good providing a safe environment. The home is clean and hygienic. EVIDENCE: A tour of the home confirmed that all of the communal facilities and the gardens are accessible to clients. There is plenty of communal space within the home. The furniture and decoration in the communal areas is of good quality and domestic in character Individual rooms were decorated to make them look light and airy. There was a room being redecorated during the inspection and new carpet was being laid in one of the lounges. Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 14 Clients rooms seen looked comfortable were clean and contained many of their own possessions. There are a variety of bathrooms and toilets throughout the home adapted to meet the needs of the clients. Most rooms have en-suite facilities. Domestic staff were seen cleaning the home during the inspection. The home was tidy, clean and staff were seen using correct infection control procedures. Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 Clients needs are met by a satisfactory mix of nurses, carers and ancillary staff who are trained and competent to do their job. EVIDENCE: The duty rota provided during the inspection showed that for the 68 clients in the home, 25 of which require personal care only, the staffing levels are above average and are monitored and reviewed according to the dependency of the clients. The homes brochure describes the type of staff who work within the home and that over 50 of care staff are qualified with NVQ 2 and 3. There are domestic staff, catering staff and administrative staff employed to support the carers in meeting the needs of the clients in the home. Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 38 There is good leadership and guidance for staff to ensure residents receive consistent quality care. The systems in place in the home generally promote and protect the health and safety and welfare of the clients and staff. EVIDENCE: The registered manager is a first level nurse and has several years experience of managing a care home with nursing. She has a Diploma in the care of the older person and will soon complete her Registered Managers Award. She demonstrated a clear leadership style during the inspection and there are clear lines of accountability within the home. Some windows on the first floor were not restricted. Advised to carry out a full audit of all first floor windows to ensure restriction is in place. Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 17 There were some medicines stored in the general fridge in one of the dining rooms. Advised that if they are to remain in the fridge they should be in an airtight container that is clearly marked. Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 3 3 x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 x x x x x x 2 Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 19 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 24 Regulation 12 (4) (a) Requirement Those rooms that are not fitted with locks must be provided with locks or evidence shown that clients have been asked whether they want locks or not. (carried forward from 01/10/04). Timescale for action 01.10.2006 2. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 38 Good Practice Recommendations Ensure all windows on the first floor are restricted to comply with Health and Safety legislation. Ensure that medicines kept in a general fridge are stored in a airtight container and clearly labelled. 2. Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Meadowside/St Francis D52-D04 S56816 Meadowside St Francis V231753 070905 Stage 4.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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